The invention relates to a method for automatically detecting the three-dimensional position of a medical examination instrument inserted into a body region, by using a device for recording radiation images with the aid of a radiation source and a radiation receiver.
So that the physician, who is guiding an endoscope or similar rigid instrument, for example, can slide the latter into the desired target zone, it is necessary for him to receive information on the respective position and/or orientation of the instrument as it is being displaced. To date, the physician receives the relevant information with the aid of fluorograms, recorded with the aid of an X-ray system, of the examination or body region. Mostly, continuous fluorograms are recorded from two different directions and/or with the aid of two image planes at a mutual angle. These are displayed to the physician next to one another on a common monitor or two mutually adjacent monitors. These two images, whose image planes are mostly mutually perpendicular, can then be used by the physician to determine the position of the instrument and detect how the instrument is moving in the space. However, it is disadvantageous in this case that the physician must look simultaneously at two monitors and/or two images, in order to obtain the required information. A further disadvantage consists in that the two images are only projection images. That is to say, all the body parts are superimposed on one another in the direction of projection. As a result, it is therefore a complicated matter for the physician to detect the actually obtaining three-dimensional geometry with the aid of these two two-dimensional projection images, and to detect how the instrument is now actually positioned in the body region, and how and in which direction he must displace it further in order to reach the desired target zone.
As an alternative thereto, it is also known, particularly in the case of rigid examination instruments, which are those concerned in the present case, to make use of navigation systems. For this purpose, one or more navigation marks are fastened to stationary positions of the patient under examination, for example the skin, a bone or the like, and on the examination instrument whose position is to be detected. The known navigation systems use optical cameras and infrared light-emitting diodes in the markings. Other techniques use acoustic or magnetic sensors. Normally, all the positions are detected with reference to the coordinate system of the navigation system and subsequently converted into the coordinate system of the C-bow, in which the images are recorded. This method, too, is very complicated.
It is the object of the invention to specify a method which permits the three-dimensional position of an examination instrument to be determined in a simple way.
In order to solve this problem, a method of the type mentioned at the beginning is provided with the following steps:
recording at least one two-dimensional projection image of the body region,
determining the positions (ui, vi) of at least three radiatively opaque markings shown in a projection image, and
determining the spatial coordinates (xl, yl, zi) of the markings in the coordinate system of the recording device with the aid of the positions (ul, vl) and the projection matrix belonging to the projection image, taking account of the known mutual geometric arrangement of the markings.
The invention offers the possibility of being able to use only one projection image to detect the three-dimensional position of an examination instrument in the coordinate system of the C-bow. With the aid of a two-dimensional projection image in which the at least three radiatively opaque markings arranged on the examination instrument are to be seen, their two-dimensional positions ul, vl in the projection image are firstly determined, and thus those in the plane of the radiation detector are determined. The mutual geometric arrangement of the markings is known in this case, that is to say it is known how the markings are mutually positioned in space and how they are arranged on the instrument. With the aid of the projection matrix, which must be known in relation to the projection image to be processed and contains all the relevant geometric data with regard to the tube and detector positions etc., relative to those in the respective projection image, it is now possible to use the determined marking positions in the projection image and the known geometric relationships with regard to the arrangement of the markings to determine where these are in space. The point is that the positions of the projections of the markings in the projection image are naturally a function of their position in space, while they are located in the beam path between the focus of the radiation source and the detector plane.
In this case, it is possible for the purpose of determining the spatial coordinates (xi, yi, zi) firstly to set up a set of linear equations for describing the direct connecting lines between the focus of the radiation source and the respective position (ul, vi) in the projection image, after which the spatial coordinates are determined from the set of equations by taking account of the geometric arrangement.
The geometric or spatial arrangement of the markings on the examination instrument can be arbitrary, for example the markings can be positioned in a line with a defined line spacing. Other positionings are also conceivable. All that is important is that their mutual arrangement, that is to say the spacing and angle that they form relative to one another be known. Again, more than three markings can be used. All that need then be ensured is that it can be detected in the projection image which three markingsxe2x80x94and at least three markings must be visible in the projection image in order to determine the spatial coordinatesxe2x80x94are actually displayed so that the corresponding geometric data can be used in this context.
In order to be able to disseminate and display the detected information informatively, it is expedient, when a plurality of two-dimensional projections which were recorded before the insertion of the examination instrument are used firstly to create a three dimensional volumetric image of the body region in which the markings are displayed. That is to say, during the in situ detection of the marking coordinates, the latter can be displayed at once, after their determination, to the physician in the three dimensional volumetric image created, so that he knows precisely where the instrument is situated. The display of the markings is very sufficient, in particular, whenever these are arranged along a line on the instrument. Of course, it is also conceivable, in addition, to display the examination instrument itself in the volumetric image. Said instrument can be fitted into the volumetric image in the correct orientation without problems after the spatial coordinates of the markings, which are fastened permanently on the rigid examination instrument, are known.
In addition to the method according to the invention, the invention further relates to a device for recording radiation images, comprising a radiation source and a radiation receiver, and image recording and calculating means. The device according to the invention is designed
for recording at least one two-dimensional projection image of a body region into which an examination instrument with at least three markings whose mutual geometric arrangement is known is inserted,
for determining the positions (ui, vl) of the at least three radiatively opaque markings shown in a projection image, and
for determining the spatial coordinates (xl, yl, zi) of the at least three markings in the coordinate system of the recording device with the aid of the positions (ul, vi) and the projection matrix belonging to the projection image by taking account of the known mutual geometric arrangement of the markings.
In this case, the image recording and calculating means can be designed for determining the spatial coordinates (xl, yl, zi) with the aid of a set of linear equations describing the direct connecting lines between the focus of the radiation source and the respective position (ui, vl) in the projection image by taking account of the geometric arrangement. Furthermore, it is possible to use the image recording and calculating means to insert either only the markings, or else the examination instrument itself into the volumetric image, which can be calculated with the aid of the two-dimensional projections. If the examination instrument is fitted in, it is expedient when there is stored in the image recording and calculating means a display of the examination instrument which is depicted in the volumetric image as a function of the determined spatial coordinates. Since, of course, the most varied examination instruments can be inserted into the body, it is expedient when images are stored which respectively correspond to the different types, can be selected or determined in advance on the part of the user and can then be depicted with accurate positioning.